Healthcare Provider Details

I. General information

NPI: 1164943502
Provider Name (Legal Business Name): NEW YORK UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 QUANTUM BLVD
BOYNTON BEACH FL
33426-8668
US

IV. Provider business mailing address

159 E 53RD ST
NEW YORK NY
10022-4602
US

V. Phone/Fax

Practice location:
  • Phone: 877-648-2964
  • Fax:
Mailing address:
  • Phone: 646-754-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANDREW T RUBIN
Title or Position: VP, CLINICAL AFFAIRS AND AMB. CARE
Credential:
Phone: 212-263-2672